I’ll summarize the most recent advances in treating milk allergy from the article below. Why is our current therapy not enough? Guess what happens when a patient allergic to milk suffers from accidental ingestion? Anaphylaxis! Why not cure the disease–Johns Hopkins is a long way from Oklahoma, but patients have access to this same research here in the Midwest.

By Will Boggs, MD

NEW YORK (Reuters Health) Jan 02 – Sublingual and oral immunotherapy may help some children with milk allergy, but clinical desensitization is quickly lost and systemic reactions occur with oral therapy, a new study shows.

“We found that both sublingual and oral immunotherapy benefited children with cow’s milk allergy in that they were able to consume much more milk without symptoms at the end of the study than they could at the beginning of the study,” said Dr. Corinne A. Keet from Johns Hopkins University School of Medicine in Baltimore.

“However, oral immunotherapy, which used higher doses, was more effective,” she told Reuters Health by email.

The new findings appeared online November 30 in the Journal of Allergy and Clinical Immunology.

All children started out on sublingual therapy, with dose escalation over six weeks. Then they were randomized to either sublingual maintenance therapy (goal dose, 7 mg) or one of two doses of oral maintenance therapy (goal dose, 1 g and 2 g). The maintenance periods lasted 60 weeks each.

“One result that surprised us was how quickly children could lose desensitization,” Dr. Keet said. “This is another reason for caution with these methods.”

“These methods are far from perfect, and I think are not ready for general use in allergy practices,” Dr. Keet concluded. “They show a lot of promise, but many aspects, including both safety and efficacy, need to be improved before widespread adoption of this method.”

“One alternative which is getting more attention recently is to use milk in baked goods to desensitize,” Dr. Keet added. “For some children, this is a good option, but some children are unable to tolerate even the small amounts of milk in baked goods needed to start desensitization. So, for many children with milk allergy there aren’t any good alternatives.”

An apple a day might keep the doctor away, but what is modern hospital medicine really like? Follow Dr. Benjamin Kirkland - a Doctor working in Australia - through the pinnacles and pitfalls of everyday hospital medicine!